? 2/05 Yum: Use R or fast track L?

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MJW

MJW

Member Since 2017
Previously: http://www.felinediabetes.com/FDMB/...negative-plus-confusingr.190498/#post-2123257

Yum has been doing better with the 6 cycle dose increases plus small R doses: pinks and reds at 12 units Lantus.

I increased her to 13 units of Lantus yesterday evening. My plan was to fast track the Lantus increases by holding this dose for 4 cycles without R.

Looking at last night’s and today’s numbers, though: maybe I should go back to 6 cycles plus R?
Maybe the tiny doses of R are doing more than an extra unit of L. Or is this NDW?

Opinions?
 
Today is probably NDW you are seeing. It often shows up in cycles 2-3 after an increase. Cycle 4 may be a better idea of what this dose can do.

I would stick with the six cycle increases at using R. When we do fast tracking, it's until kitties start to see yellow, and given that you are using at AT and have seen yellow, I wouldn't move too fast.
 
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Okay. I am sooo curious what she would do on the 4th cycle w/o R, but I am even more anxious to see pink and yellow again. R it is again tonight.
 
Have you made a decision in regards to Yum's treatment? I am curious... We are still researching and my vet mentioned Missouri State... However, I have absolutely no information on it as of yet.
 
I haven't made any decisions.
I put her on cabergoline, just in case that might work for her. It is a long shot, but worth a try. 7 days in, no miracles. She's had a bit of diarrhea, but only intermittent and not severe.
My emotional reaction is she is too old for a long trip, repeated anesthesia, and surgery or radiotherapy. RVC reports 14% of cats do not recover from hypophysectomy---and they have the best surgery team. I'm sure older cats have higher mortality rates. On the forum, people have had variable results with SRT. Often it takes many months for the benefits to appear.
Yum will turn 16 in less than a month. Her kidneys aren't great. The cardiologist said her heart was good in August, but she has a grade 3 murmur and a growing pituitary tumor.
I am contemplating how to quantify her risks.
I am going to have her blood pressure rechecked, this week or next.
I might get an opinion from an IM vet. I might try getting feedback from CSU and NCSU, after describing her condition.
I am looking at pasireotide, letting the shock of the cost sink in. Maybe there are "deals" for cats. Probably not. It can have side effects too.

I need to make progress on risk evaluation this week. Vets always leave these decisions up to the care giver, but they should be able to give me statistics.
I have a 3 week cushion while I wait for a miracle with cabergoline.
 
MJW said:
Yum is happier with her numbers in the pinks than when they were in the blacks.
She is drinking less water; she wants more cuddles; she is requesting to be brushed
again.
Click to expand...

Love to hear this! Vines for continued improvements and better spirits for Yum! :cat:

I hope you can find a more economical way to get the pasireotide if that is looking like the best option. And, of course, I hope you get a cabergoline miracle! :bighug:
 
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